EP1113810B1 - Methods of treating multiple myeloma and myeloma-induced bone resorption using antagonists of integrin / receptor binding - Google Patents

Methods of treating multiple myeloma and myeloma-induced bone resorption using antagonists of integrin / receptor binding Download PDF

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EP1113810B1
EP1113810B1 EP99949656A EP99949656A EP1113810B1 EP 1113810 B1 EP1113810 B1 EP 1113810B1 EP 99949656 A EP99949656 A EP 99949656A EP 99949656 A EP99949656 A EP 99949656A EP 1113810 B1 EP1113810 B1 EP 1113810B1
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antibody
antigen
binding fragment
vla
cells
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EP1113810A2 (en
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Gregory R. Mundy
Toshiyuki Yoneda
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University of Texas System
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2803—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
    • C07K16/2836—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against CD106
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A61P35/02—Antineoplastic agents specific for leukemia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/705—Receptors; Cell surface antigens; Cell surface determinants
    • C07K14/70503—Immunoglobulin superfamily
    • C07K14/70542—CD106
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2839—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the integrin superfamily
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2839—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the integrin superfamily
    • C07K16/2842—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the integrin superfamily against integrin beta1-subunit-containing molecules, e.g. CD29, CD49
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides

Definitions

  • the present invention relates to the use of an antibody or antigen-binding fragment thereof or of a soluble VLA-4 or VCAM-1 polypeptide for the preparation of a pharmaceutical composition for the treatment of multiple myeloma, and the release of bone-resorbing factors by myeloma cells, resulting in severe bone loss, which is the major side-effect of myeloma in man.
  • this invention relates to the use of an anti-VLA-4 antibody or antigen-binding fragment thereof, of an anti-alpha 4/beta 7 integrin antibody or antigen-binding fragment thereof or of an anti-VCAM-1 antibody or antigen-binding fragment thereof, or of soluble VLA-4 or VCAM-1 polypeptides that antagonize the VLA-4/VCAM-1 interaction for the preparation of pharmaceutical compositions for such a treatment.
  • Osteolytic bone lesions are by far the most common skeletal manifestations in patients with myeloma (Mundy, 1998). Although the precise molecular mechanisms remain unclear, observations over 15 years have shown that: 1) The mechanism by which bone is destroyed in myeloma is via the osteoclast, the normal bone-resorbing cell; 2) Osteoclasts accumulate on bone-resorbing surfaces in myeloma adjacent to collections of myeloma cells and it appears that the mechanism by which osteoclasts are stimulated in myeloma is a local one; 3) It has been known for many years that cultures of human myeloma cells in vitro produce several osteoclast activating factors, including lymphotoxin-alpha (LT-a), interleukin-1 (IL-1), parathyroid-hormone related protein (PTHrP) and interleukin-6 (IL-6); 4) Hypercalcemia occurs in approximately one-third of patients with myeloma some time during the course of the disease.
  • Hypercalcemia is always associated with markedly increased bone resorption and frequently with impairment in glomerular filtration; 5)
  • the increase in osteoclastic bone resorption in myeloma is usually associated with a marked impairment in osteoblast function.
  • Alkaline phosphatase activity in the serum is decreased or in the normal range, unlike patients with other types of osteolytic bone disease, and radionuclide scans do not show evidence of increased uptake, indicating impaired osteoblast responses to the increase in bone resorption.
  • IL-6 is a major myeloma growth factor that enhances the growth of several myeloma cell lines and freshly isolated myeloma cells from patients (Bataille et al., 1989).
  • IL-6 production can be detected in about 40% of freshly isolated myeloma cells by PCR, but only 1 in 150 patients studied show detectable IL-6 production by immunocytochemistry or ELISA assays (Epstein 1992).
  • the IL-6 receptors were only detected in 6 of 13 samples from patients with multiple myeloma (Bataille et al, 1992).
  • mature myeloma cells have been reported to have a minimal proliferative response to IL-6.
  • Interleukin-11 IL-11
  • IL-1 is an extremely potent bone-resorbing agent that induces hypercalcemia in animal models in the absence of renal failure (Boyce et al, 1989). In contrast, hypercalcemia rarely occurs in myeloma patients without renal failure. More importantly, in highly purified myeloma cells, no IL-1 and only rare TNF-a production can be detected, suggesting that other contaminating cell types such as macrophages may be the source of IL-1 and TNF-a (Epstein 1992).
  • LT-a is produced by most human myeloma cell lines (Bataille et al, 1995) but does not appear to be produced by myeloma cells in vivo (Alsina et al, 1996).
  • myeloma cells produce a truncated form of M-CSF which is biologically active, but M-CSF does not cause hypercalcemia or induce osteoclast formation by itself in human marrow cultures (MacDonald et al, 1986).
  • Vanderkerken et al (1997) also examined the phenotypic adhesion profile of murine 5T2 cells and 5T33 myeloma cells in a model of murine myeloma. These investigators showed that these cell lines expressed VLA-4, VLA-5, LFA-1, and CD44, and suggested that these adhesive interactions might be important for myeloma cells to bind to marrow stromal cells.
  • VLA-4 integrin VLA-4 has been studied in metastasis of multiple tumors, including leukemias such as lymphoma, with contradictory results.
  • transfection of the human alpha 4 chain into Chinese Hamster Ovary (CHO) cells resulted in VLA-4 expression, and rendered these cells able to migrate to bone marrow in vivo, a phenomenon inhibited by mAbs to VLA-4 (Matsuura et al, 1996).
  • transfection of lymphoma cells with VLA-4 strongly inhibited metastasis to liver, lung and kidney, and was without effect on homing and proliferation in marrow (Gosslar et al., 1996).
  • One aspect of the invention is the use of an anti-VLA-4 antibody, an anti-alpha 4/beta 7 integrin antibody or an anti-VCAM-1 antibody or antigen-binding fragments thereof for the preparation of a pharmaceutical composition for the treating of multiple myeloma.
  • Preferred agents are human, chimeric, humanised anti-VLA4 or anti-alpha4beta7 antibody, antigen-binding antibody and fragments thereof); anti-VCAM-1 antibody homologs (a human antibody, a chimeric antibody, a humanized antibody and fragments thereof).
  • the composition can be administered at a dosage so as to provide from about 0.1 to about 20 mg/kg body weight.
  • the preferred agents can antagonize an interaction: a) of both VLA-4 and alpha4 beta 7 collectively with their respective alpha4 ligands; or b) only of VLA-4 with its alpha4 ligand; or c) only of alpha4beta7 with its alpha4 ligand.
  • Another aspect of the invention is the use of soluble VLA-4 or VCAM-1 polypeptide that antagonizes the VLA-4/VCAM-1 interaction for the preparation of a pharmaceutical composition for treating multiple myeloma.
  • Another aspect of the invention is the use of an anti-VLA-4 antibody, an anti-alpha 4/beta 7 integrin antibody or an anti-VCAM-1 antibody or antigen-binding fragments thereof for the preparation of a pharmaceutical composition for inhibiting bone resorption associated with tumors of bone marrow.
  • Preferred agents are anti-VLA4 or anti alpha4beta7 antibody (human antibody, a chimeric antibody, a humanized antibody and antigen-binding fragments thereof); anti-VCAM-1 antibody (a human antibody, a chimeric antibody, a humanized antibody and fragments thereof).
  • the agent can be administered at a dosage so as to provide from about 0.1 to about 20 mg/kg body weight.
  • Another aspect of the invention is the use of soluble VLA-4 or VCAM-1 polypeptide that antagonizes the VLA-4/VCAM-1 interaction for the preparation of a pharmaceutical composition for inhibiting bone resorption associated with a tumor of bone marrow.
  • the composition can be administered at a dosage so as to provide from about 0.1 to about 20mg/kg body weight.
  • VCAM-1 Ab anti-VCAM-1 antibody
  • ⁇ 4 ⁇ 11Ab anti-alpha4betal antibody
  • ICAM-1 Ab anti-ICAM-1 antibody
  • rat IgG rat IgG
  • mice were injected with 1e5 5TGM1 cells, which were allowed to colonize the bone marrow. Mice were split into two groups of three, one serving as a control group, and the second treated on days 8, 11, 14, 17, and 20 with 80 ug mAb PS/2 ( ⁇ 4 mg/kg). Levels of IgG2b, the antibody isotype produced by 5TGM1 myeloma cells, were measured weekly from weeks 1 to 6. Mab treatment strongly inhibited IgG2b production, indicative of inhibition of myeloma cell survival and growth in vivo.
  • mice were injected with 5TGM1 cells as described in Figure 4 , which were allowed to colonize the bone marrow. Mice were split into groups of four or five, one group serving as a control group (open square), the second/third groups treated prophylactically at 80 ug (open diamonds) and 160 ug mAb (open circles) ( ⁇ 4 to 8 mg/kg), the fourth group treated therapeutically at 160 ug mAb (triangles).
  • Levels of IgG2b the antibody isotype produced by 5TGM1 myeloma cells, were measured. Mab treatment strongly inhibited IgG2b production, indicative of inhibition of myeloma cell survival and growth in vivo.
  • the invention relates to treatments for, among other things, preventing multiple myeloma. More particularly, methods of the invention relate to the use of antibody or polypeptide antagonists of an interaction between an integrin containing an alpha4 subunit and a ligand for this integrin in the treatment of multiple myeloma.
  • the term "multiple myeloma" is intended to mean a medical condition in an individual having a neoplastic disease of plasma cells, with the neoplastic clone representing cells at different stages in the plasma cell lineage from patient to patient (Mundy, 1998).
  • Alpha 4 beta 1 integrin is a cell-surface receptor for VCAM-1, fibronectin and possibly other molecules that bind with, or otherwise interact with, alpha 4 beta 1 integrin.
  • such molecules that bind with, or otherwise interact with, alpha 4 subunit containing integrin are individually and collectively referred to as "alpha4 ligand(s)").
  • VLA-4" or a4b1 or “a4b1 integrin”, used interchangeably
  • VLA-4 polypeptides which are capable of binding to VCAM-1 and members of the extracellular matrix proteins, most particularly fibronectin, or homologs or fragments thereof, although it will be appreciated by workers of ordinary skill in the art that other ligands for VLA-4 may exist and can be analyzed using conventional methods.
  • alpha4 subunit will associate with other beta subunits besides beta1 so that we may define the term "alpha 4 integrin” as being those integrins whose alpha4 subunit associates with one or another of the beta subunits.
  • alpha4 integrin A further example of an "alpha4" integrin is alpha4beta7 (R. Lobb and M Hemler, 1994).
  • alpha4 integrin(s) means VLA-4, as well as integrins that contain beta 1, beta7 or any other beta subunit.
  • an agent that antagonizes the action of more than one alpha 4 integrin such as an antibody that antagonizes several alpha 4 integrins such as VLA-4 and alpha4 beta 7, or other combinations of alpha4 integrins.
  • methods using a combination of different molecules such that the combined activity antagonizes the action of more than one alpha4 integrin, such as methods using several antibody that in combination antagonize the alpha 4 integrins VLA-4 and alpha4 beta 7.
  • antibodies discussed below as well as soluble forms of the natural binding proteins for VLA-4 and VCAM-1 are useful.
  • VCAM-1 in another example, VCAM-1, or a fragment thereof which is capable of binding to VLA-4 on the surface of VLA-4 bearing Myeloma cells, e.g., a fragment containing the two N-terminal domains of VCAM-1, can be fused to a second peptide, e.g., a peptide which increases the solubility or the in vivo life time of the VCAM- 1 moiety.
  • the second peptide can be a fragment of a soluble peptide, preferably a human peptide, more preferably a plasma protein, or a member of the inununoglobulin superfamily.
  • the agent that is used in the medical uses of the invention to bind to, including block or coat, cell-surface alpha4 integrin and/or alpha4 integrin ligand is an anti-VLA-4 and/or anti-alpha4beta7 monoclonal antibody.
  • Preferred antibodies for treatment include human antibody, humanized antibody chimeric antibody, Fab, Fab', F(ab')2 and F(v) antibody fragments, and monomers or dimers of antibody heavy or light chains or mixtures thereof.
  • Monoclonal antibodies against VLA-4 are a preferred binding agent in the method of the invention.
  • antibody includes intact antibodies consisting of immunoglobulin light and heavy chains linked via disulfide bonds.
  • antibody is also intended to encompass a protein comprising one or- more polypeptides selected from immunoglobulin light chains, immunoglobulin heavy chains and antigen-binding fragments thereof which are capable of binding to one or more antigens.
  • the component polypeptides of an antibody homolog composed of more than one polypeptide may optionally be disulfide-bound or otherwise covalently crosslinked.
  • antibody include intact immunoglobulins of types IgA, IgG, IgE, IgD, IgM (as well as subtypes thereof), wherein the light chains of the immunoglobulin may be of types kappa or lambda.
  • Antibody also include portions of intact antibodies that retain antigen-binding specificity, for example, Fab fragments, Fab' fragments, F(ab')2 fragments, F(v) fragments, heavy chain monomers or dimers, light chain monomers or dimers, dimers consisting of one heavy and one light chain, and the like.
  • Fab fragments fragments, Fab' fragments, F(ab')2 fragments, F(v) fragments
  • heavy chain monomers or dimers heavy chain monomers or dimers
  • light chain monomers or dimers dimers consisting of one heavy and one light chain, and the like.
  • a “humanized antibody” is an antibody, produced by recombinant DNA technology, in which some or all of the amino acids of a human immunoglobulin light or heavy chain that are not required for antigen binding have been substituted for the corresponding amino acids from a nonhuman mammalian immunoglobulin light or heavy chain.
  • a "chimeric antibody” is an antibody, produced by recombinant DNA technology, in which all or part of the hinge and constant regions of an immunoglobulin light chain, heavy chain, or both, have been substituted for the corresponding regions from another immunoglobulin light chain or heavy chain.
  • the invention features a variant of a chimeric molecule which includes: (1) a VLA-4 targeting moiety, e.g., a VCAM-1 moiety capable of binding to antigen (i.e., VLA-4) on the surface of VLA-4 bearing myeloma cells; (2) optionally, a second peptide, e.g., one which increases solubility or in vivo life time of the VLA-4 targeting moiety, e.g., a member of the immunoglobulin superfamily or fragment or portion thereof, e.g., a portion or a fragment of IgG, e.g., the human IgG1 heavy chain constant region, e.g., CH2 and CH3 hinge regions; and a toxin moiety.
  • VLA-4 targeting moiety e.g., a VCAM-1 moiety capable of binding to antigen (i.e., VLA-4) on the surface of VLA-4 bearing myeloma cells
  • a second peptide e
  • the VLA-4 targeting moiety can be any naturally occurring VLA-4 ligand or fragment thereof, e.g., a VCAM-1 peptide or a similar conservatively substituted amino acid sequence.
  • a preferred targeting moiety is a soluble VCAM- 1 fragment, e.g., the N-terminal domains 1 and 2 of the VCAM-1 molecule.
  • the chimeric molecule can be used to treat a subject, e.g., a human, at risk for disorder, e.g., multiple myeloma, characterized by the presence of myeloma cells bearing VLA-4, and preferably activated VLA-4.
  • a "human antibody” is an antibody produced by recombinant DNA technology, in which all of the amino acids of an immunoglobulin light or heavy chain that are derived from a human source.
  • an immortal cell line typically myeloma cells
  • lymphocytes typically splenocytes
  • a given antigen e.g., VLA-4
  • the culture supernatants of the resulting hybridoma cells are screened for antibodies against the antigen. See, generally, Kohler et at., 1975, Nature, 265: 295-297 .
  • Immunization may be accomplished using standard procedures.
  • the unit dose and immunization regimen depend on the species of mammal immunized, its immune status, the body weight of the mammal, etc.
  • the immunized mammals are bled and the serum from each blood sample is assayed for particular antibodies using appropriate screening assays.
  • anti-VLA-4 antibodies may be identified by immunoprecipitation of 125I-labeled cell lysates from VLA-4-expressing cells. (See, Sanchez-Madrid et al. 1986, Eur. J. Immunol., 16: 1343-1349 and Hemler et al. 1987, J. Biol. Chem., 262, 11478-11485 ).
  • Anti-VLA-4 antibodies may also be identified by flow cytometry, e.g., by measuring fluorescent staining of Ramos cells incubated with an antibody believed to recognize VLA-4 (see, Elices et al., 1990 Cell, 60: 577-584 ).
  • the lymphocytes used in the production of hybridoma cells typically are isolated from immunized mammals whose sera have already tested positive for the presence of anti-VLA-4 antibodies using such screening assays.
  • the immortal cell line (e.g., a myeloma cell line) is derived from the same mammalian species as the lymphocytes.
  • Preferred immortal cell lines are mouse myeloma cell lines that are sensitive to culture medium containing hypoxanthine, aminopterin and thymidine ("HAT medium”).
  • HAT medium containing hypoxanthine, aminopterin and thymidine
  • HAT-sensitive mouse myeloma cells are fused to mouse splenocytes using 1500 molecular weight polyethylene glycol (“PEG 1500").
  • Hybridoma cells resulting from the fusion are then selected using HAT medium, which kills unfused and unproductively ftised myeloma cells (unfused splenocytes die after several days because they are not transformed).
  • Hybridomas producing a desired antibody are detected by screening the hybridoma culture supernatants.
  • hybridomas prepared to produce anti-VLA-4 antibodies may be screened by testing the hybridoma culture supernatant for secreted antibodies having the ability to bind to a recombinant alpha4-subunit-expressing cell line (see, Elices et al., supra).
  • hybridoma cells that tested positive in such screening assays were cultured in a nutrient medium under conditions and for a time sufficient to allow the hybridoma cells to secrete the monoclonal antibodies into the culture medium. Tissue culture techniques and culture media suitable for hybridoma cells are well known. The conditioned hybridoma culture supernatant may be collected and the anti-VLA4 antibodies optionally further purified by well-known methods.
  • the desired antibody may be produced by injecting the hybridoma cells into the peritoneal cavity of an unimmunized mouse.
  • the hybridoma cells proliferate in the peritoneal cavity, secreting the antibody which accumulates as ascites fluid.
  • the antibody may be harvested by withdrawing the ascites fluid from the peritoneal cavity with a syringe.
  • anti-VLA-4 monoclonal antibodies have been previously described. See, e.g., Sanchez-Madrid et al., 1986, supra; Hemler et al., 1987, supra; Pulido et al., 1991, J. Biol. Chem., 266 (16), 10241-10245 ).
  • anti-VLA-4 monoclonal antibodies such as HP 1/2 and other anti-VLA-4 antibodies (e.g., HP2/1, HP2/4, L25, P4C2, P4G9) capable of recognizing the P chain of VLA-4 will be useful in the methods of treatment according to the present invention.
  • AntiVLA-4 antibodies that will recognize the VLA-4 alpha4 chain epitopes involved in binding to VCAM-1 and fibronectin ligands (i.e., antibodies which can bind to VLA-4 at a site involved in ligand recognition and block VCAM-1 and fibronectin binding) are preferred. Such antibodies have been defined as B epitope-specific antibodies (B1 or B2) (Pulido et al., 1991, supra) and are also anti-VLA-4 antibodies according to the present invention.
  • B1 or B2 B epitope-specific antibodies
  • Fully human monoclonal antibody homologs against VLA-4 are another preferred binding agent which may block or coat VLA-4 antigens in the method of the invention.
  • these may be prepared using in vitro-primed human splenocytes, as described by Boerner et al., 1991, J. Immunol., 147, 86-95 .
  • they may be prepared by repertoire cloning as described by Persson et al., 1991, Proc. Nat. Acad. Sci. USA, 88: 2432-2436 or by Huang and Stollar, 1991, J. Immunol. Methods 141, 227-236 .
  • U.S. Patent 5,798,230 (Aug.
  • human antibody-producing B cells are immortalized by infection with an Epstein-Barr virus, or a derivative thereof, that expresses Epstein-Barr virus nuclear antigen 2 (EBNA2).
  • EBNA2 function which is required for immortalization, is subsequently shut off, which results in an increase in antibody production.
  • United States Patent 5,789,650 (Aug. 4, 1998, " Transgenic non-human animals for producing heterologous antibodies") describes transgenic non-human animals capable of producing heterologous antibodies and transgenic non-human animals having inactivated endogenous immunoglobulin genes. Endogenous immunoglobulin genes are suppressed by antisense polynucleotides and/or by antiserum directed against endogenous immunoglobulins. Heterologous antibodies are encoded by immunoglobulin genes not normally found in the genome of that species of non-human animal.
  • transgenes containing sequences of unrearranged heterologous human immunoglobulin heavy chains are introduced into a non-human animal thereby forming a transgenic animal capable of functionally rearranging transgenic immunoglobulin sequences and producing a repertoire of antibodies of various isotypes encoded by human immunoglobulin genes.
  • Such heterologous human antibodies are produced in B-cells which are thereafter immortalized, e.g., by fusing with an immortalizing cell line such as a myeloma or by manipulating such B-cells by other techniques to perpetuate a cell line capable of producing a monoclonal heterologous, fully human antibody homolog.
  • phage display libraries may also be used to isolate high affinity antibodies that can be developed as human therapeutics using standard phage technology (Vaughan et al, 1996).
  • Yet another preferred binding agent which may block or coat VLA-4 antigens in the method of the invention is a humanized recombinant antibody homolog having anti-VLA-4 specificity.
  • a new approach was described in EP 0239400 (Winter et al. ) whereby antibodies are altered by substitution of their complementarity determining regions (CDRs) for one species with those from another. This process may be used, for example, to substitute the CDRs from human heavy and light chain Ig variable region domains with alternative CDRs from murine variable region domains.
  • Ig variable regions may subsequently be combined with human Ig constant regions to created antibodies which are totally human in composition except for the substituted murine CDRs.
  • CDR-substituted antibodies would be predicted to be less likely to elicit an immune response in humans compared to chimeric antibodies because the CDR-substituted antibodies contain considerably less non-human components.
  • the process for humanizing monoclonal antibodies via CDR "grafting" has been termed "reshaping". ( Riechmann et al., 1988, Nature 332, 323-327 ; Verhoeyen et al., 1988, Science 239, 1534-1536 ).
  • CDRs complementarity determining regions
  • a murine antibody is transplanted onto the corresponding regions in a human antibody, since it is the CDRs (three in antibody heavy chains, three in light chains) that are the regions of the mouse antibody which bind to a specific antigen.
  • Transplantation of CDRs is achieved by genetic engineering whereby CDR DNA sequences are determined by cloning of murine heavy and light chain variable (V) region gene segments, and are then transferred to corresponding human V regions by site directed mutagenesis.
  • V murine heavy and light chain variable
  • human constant region gene segments of the desired isotype (usually gamma I for CH and kappa for CL) are added and the humanized heavy and - light chain genes are co-expressed in mammalian cells to produce soluble humanized antibody.
  • the tertiary structure of the murine V region is modelled by computer in order to visualize framework amino acid residues which are likely to interact with the murine CDRs and these murine amino acid residues are then superimposed on the homologous human framework. See also Protein Design Labs - U.S. Patent 5,693,762 .
  • Tempest et al.,1991, Biotechnology 9, 266-271 utilize, as standard, the V region frameworks derived from NEWM and REI heavy and light chains respectively for CDR-grafting without radical introduction of mouse residues.
  • An advantage of using the Tempest et al., approach to construct NEWM and REI based humanized antibodies is that the 3dimensional structures of NEWM and REI variable regions are known from x-ray crystallography and thus specific interactions between CDRs and V region framework residues can be modeled.
  • Preferred antagonists useful in the present invention include chimeric recombinant and humanized recombinant antibody homologs (i.e., intact immunoglobulins and portions thereof) with B epitope specificity that have been prepared and are described in co-pending U.S. Patent Application Serial No. 08/004,798, filed January 12, 1993 , PCT Publication US94/00266, filed January 7, 1994 .
  • the starting material for the preparation of chimeric (mouse V - human C) and humanized anti-VLA-4 antibody homologs may be a murine monoclonal anti-VLA-4 antibody as previously described, a monoclonal anti-VLA-4 antibody commercially available (e.g., HP2/1, Amae International, Inc., Westbrook, Maine), or a monoclonal anti-VLA-4 antibody prepared in accordance with the teaching herein.
  • the variable regions of the heavy and light chains of the anti-VLA-4 antibody HP 1 ⁇ 2 have been cloned, sequenced and expressed in combination with constant regions of human immunoglobulin heavy and light chains.
  • Such HP 1 ⁇ 2 antibody is similar in specificity and potency to the murine HP 1/2 antibody, and may be useful in methods of treatment according to the present invention.
  • humanized anti-VLA4 antibody homologs are described by Athena Neurosciences, Inc. in PCT/US95/01219 (27 July 1995 )
  • These humanized anti-VLA-4 antibodies comprise a humanized light chain and a humanized heavy chain.
  • the humanized light chain comprises three complementarity determining regions (CDR1, CDR2 and CDR3) having amino acid sequences from the corresponding complementarity determining regions of a mouse 21.6 immunoglobulin light chain, and a variable region framework from a human kappa light chain variable region framework sequence except in at least position the amino acid position is occupied by the same amino acid present in the equivalent position of the mouse 21.6 immunoglobulin light chain variable region framework.
  • the humanized heavy chain comprises three complementarity determining regions (CDR1, CDR2 and CDR3) having amino acid sequences from the corresponding complementarity determining regions of a mouse 21.6 immunoglobulin heavy chain, and a variable region framework from a human heavy chain variable region framework sequence except in at least one position the amino acid position is occupied by the same amino acid present in the equivalent position of the mouse 21.6 immunoglobulin heavy chain variable region framework.
  • VLA-4 binding agents in particular, VCAM fusions and anti-VLA-4 antibody homologs are preferably administered parenterally.
  • parenteral includes subcutaneous, intravenous, intramuscular, intra-articular, intra-synovial, intrasternal, intrathecal, intrahepatic, intralesional and intracranial injection or infusion techniques
  • the VLA-4 binding agents are preferably administered as a sterile pharmaceutical composition containing a pharmaceutically acceptable carrier, which may be any of the numerous well known carriers, such as water, saline, phosphate buffered saline, dextrose, glycerol, ethanol, and the like, or combinations thereof.
  • a pharmaceutically acceptable carrier such as water, saline, phosphate buffered saline, dextrose, glycerol, ethanol, and the like, or combinations thereof.
  • the compounds of the present invention may be used in the form of pharmaceutically acceptable salts derived from inorganic or organic acids and bases.
  • acid salts include the following: acetate, adipate, alginate, aspartate, benzoate, benzenesulfonate, bisulfate, butyrate, citrate, camphorate, camphorsulfonate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptanoate, glycerophosphate, hemisulfate, heptanoate, hexanoate, hydrochloride, hydrobromide, hydroiodide, 2-hydroxyethanesulfonate, lactate, maleate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, oxalate, pamoate, pectinate, persulfate, 3-phenyl-propionate, picrate, pivalate, propionate, succinate, tartrate, thiocyan
  • Base salts include ammonium salts, alkali metal salts, such as sodium and potassium salts, alkaline earth metal salts, such as calcium and magnesium salts, salts with organic bases, such as dicyclohexylamine salts, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine and salts with amino acids such as arginine, lysine, and so forth.
  • the basic nitrogen-containing groups can be quaternized with such agents as lower alkyl halides, such as methyl, ethyl, propyl, and butyl chloride, bromides and iodides; dialkyl sulfates, such as dimethyl, diethyl, dibutyl and diamyl sulfates, long chain halides such as decyl, lauryl, myristyl and stearyl chlorides, bromides and iodides, aralkyl halides, such as benzyl and phenethyl bromides and others. Water or oil-soluble or dispersible products are thereby obtained.
  • lower alkyl halides such as methyl, ethyl, propyl, and butyl chloride, bromides and iodides
  • dialkyl sulfates such as dimethyl, diethyl, dibutyl and diamyl sulfates
  • long chain halides such
  • compositions of this invention comprise any of the compounds of the present invention, or pharmaceutically acceptable derivatives thereof, together with any pharmaceutically acceptable carrier.
  • carrier includes acceptable adjuvants and vehicles.
  • Pharmaceutically acceptable carriers that may be used in the pharmaceutical compositions of this invention include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, polyethylene glycol
  • the pharmaceutical compositions may be in the form of a sterile injectable preparation, for example a sterile injectable aqueous or oleaginous suspension.
  • This suspension may be formulated according to techniques - known in the art using suitable dispersing or wetting agents and suspending agents.
  • the sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example as a solution in 1,3-butanediol.
  • the acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution.
  • sterile, fixed oils are conventionally employed as a solvent or suspending medium.
  • any bland fixed oil may be employed including synthetic mono- or di-glycerides.
  • Fatty acids such as oleic acid and its glyceride derivatives are useful in the preparation of injectable, as do natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions.
  • These oil solutions or suspensions may also contain a long-chain alcohol diluent or dispersant, such as Ph. Helv or similar alcohol.
  • compositions of this invention may be given parenterally or orally. If given orally, they can be administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, aqueous suspensions or solutions.
  • carriers which are commonly used include lactose and corn starch.
  • Lubricating agents, such as magnesium stearate, are also typically added.
  • useful diluents include lactose and dried corn starch.
  • aqueous suspensions are required for oral use, the active ingredient is combined with emulsifying and suspending agents. If desired, certain sweetening, flavoring or coloring agents may also be added. Topically-transdermal patches may also be used.
  • compositions of this invention may also be administered by nasal aerosol or inhalation through the use of a nebulizer, a dry powder inhaler or a metered dose inhaler.
  • a nebulizer a dry powder inhaler or a metered dose inhaler.
  • Such compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other conventional solubilizing or dispersing agents.
  • compositions containing a compound of this invention may also comprise an additional agent selected from the group consisting of corticosteroids, antiinflammatories, immunosuppressants, antimetabolites, and immunomodulators.
  • additional agent selected from the group consisting of corticosteroids, antiinflammatories, immunosuppressants, antimetabolites, and immunomodulators.
  • Specific compounds within each of these classes may be selected from anv of those listed under the appropriate group headings in " Comprehensive Medical Chemistry", Pergamon Press, Oxford, England, pp. 970-986 (1990 ).
  • Also included within this group are compounds such as theophylline, sulfasalazine ana aminosalicylates (antiinflammatories); cyclosporin, FK-506, and rapamycin (immunosuppressants); cyclophosphamide and methotrexate (antimetabolites); steroids (inhaled, oral or topical) and interferons (immunomodulators).
  • the amount of active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated, and the particular mode of administration. It should be understood, however, that a specific dosage and treatment regimen for any particular patient will depend upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, rate of excretion, drug combination, and the judgment of the treating physician and the severity of the particular disease being treated. The amount of active ingredient may also depend upon the therapeutic or prophylactic agent, if any, with which the ingredient is co-administered.
  • the dosage and dose rate of the compounds of this invention effective to prevent, suppress or inhibit cell adhesion will depend on a variety of factors, such as the nature of the inhibitor, the size of the patient, the goal of the treatment, the nature of the pathology to be treated, the specific pharmaceutical composition used, and the judgment of the treating physician. Dosage levels of between about 0.001 and about 100 mg/kg body weight per day, preferably between about 0.1 and about 50 mg/kg body weight per day of the active ingredient compound are useful. Most preferably, the VLA-4 binding agent, if an antibody or antibody derivative, will be administered at a dose ranging between about 0.
  • an antibody composition is administered in an amount effective to provide a plasma level of antibody of at least 1 mg/ml. Optimization of dosages can be determined by administration of the binding agents, followed by assessment of the coating of VLA-4-positive cells by the agent over time after administered at a given dose in vivo.
  • Myeloma cells contained in a sample of the individual's peripheral blood (or bone marrow cells) should be probed for the presence of the agent in vitro (or ex vivo) using a second reagent to detect the administered agent.
  • a second reagent to detect the administered agent.
  • this may be a fluorochrome labelled antibody specific for the administered agent which is then measured by standard FACS (fluorescence activated cell sorter) analysis.
  • presence of the administered agent may be detected in vitro (or ex vivo) by the inability or decreased ability of the individual's cells to bind the same agent which has been itself labelled (e.g., by a fluorochrome).
  • the preferred dosage should produce detectable coating of the vast majority of VLA-4-positive cells. Preferably, coating is sustained in the case of an antibody homolog for a 1-14 day period.
  • mice inoculated with cultured cells develop disease in a highly predictable and reproducible manner, which includes formation of a monoclonal gammopathy and radiologic bone lesions. Furthermore, some of the mice become hypercalcemic, and the bone lesions are characterized by increased osteoclast activity. Thus, based on histological examination of affected organs in STGM1-bearing mice and increased serum levels of IgG2b, 5TGM1 is defined as a murine myeloma which recapitulates accurately the hallmarks of human disease.
  • 5TGM1 myeloma cells were initially derived from a myeloma which arose spontaneously in aged C57BL/KaLwRij mice (Garrett 1997, Vanderkerken 1997). Cells were grown in Isocove's Modified Dulbecco's Medium (IMDM, Life Technologies Inc., Gaithersburg, MD) supplemented with 10% fetal bovine serum (FBS, Summit, Fort Collins, CO) and 1 % penicillin-streptomycin solution (GIBCO, Grand Island, NY) at 37 C in 5% C02 atmosphere. For in vitro experimentation described below, 5TGM1 cells between passage 25 and 30 were used.
  • IMDM Isocove's Modified Dulbecco's Medium
  • FBS fetal bovine serum
  • GBCO penicillin-streptomycin solution
  • the primers used for PCR were as follows: murine VCAM-1 5'-primer; 5'-OH-GCTGCGCGTCACCATTGTTCTC-3'-OH [SEQ ID NO: 1]; murine VCAM-1 3'-primer; 5'-OH-ACCACCCTCTTGAAGCCTTGTG-3'-OH [SEQ ID NO: 2] ; murine integrin alpha4 5'- primer; 5'-OH-CCCCTCAACACGAACAGATAGG-3'-OH [SEQ ID NO: 3]; murine integrin alpha4 3'-primer; 5'-OH-GCCTTGTCCTTAGCAACACTGC-3'-OH [SEQ IDNO: 4].
  • PCR was performed for 30 cycles consisting of 1 min at 94°C, 1 min at 55° C and 2 min at 72° C.
  • PCR reaction mixture contained 10 microliters.
  • First strand cDNA 50 mM KCl, 10 mM Tris-HCI (pH 8.3), 2 mM MgCl 2 , deoxy-NTP mix (0.2 mM each), the pair of primers (0.15 micromolar each) and 2 U Taq DNA polymerase (Perkin-Elmer, Branchburg, NJ).
  • the PCR products were separated on 2.5% agarose gels containing ethidium bromide and visualized under ultraviolet light. The size of the fragments were confirmed by reference to molecular weight markers.
  • ST2 cells (5 e 4/well) were seeded in 48-well culture plates (Costar, Cambridge, MA) and cultured 48 h in alphaMEM supplemented with 10% FBS until confluency.
  • 5TGM1 cells (5 e 6) were labeled by incubation with 10 microCi [methyl- 3H] thymidine (New England Nuclear) for 24 h at 37° C in the culture medium. After the ST2 monolayer was formed, it was incubated with 1 % bovine serum albumin (BSA, Sigma, St Louis, MO) in serum-free alphaMEM for 1 hours and tritium-labeled 5TGM1 cells were plated onto the monolayer.
  • BSA bovine serum albumin
  • the system was incubated in the absence or presence of antibodies to VCAM-1 or alpha4beta1 integrin at 37°C for 1 h.
  • Non-adherent cells were removed by washing with 5% trichloroacetic acid twice and PBS twice, and adherent cells were solubilized in 300 microliters of 0.25 mM NaOH, neutralized with the same volume of 0.25 mM HCI and the radioactivity was determined in a liquid scientillation counter.
  • Mouse bone marrow cells were obtained from 5-week-old male C57BL mice as described previously (Yoneda 1993). Femurs and tibiae were dissected aseptically and both ends cut off. Bone marrow cells were flushed out, collected and incubated in alphaMEM supplemented with 10% FBS (Hyclone, Logan, UT) and 1 % penicillin-streptomycin in 100 mm-culture dishes (Becton Dickinson Labware, Bedford, MA) at 37°C for 2 h. Non-adherent cells containing hemopoietic osteoclast precursors and stromal cellls were harvested.
  • Bone marrow cells (1 e 6) and 5TGM1 cells (1 e 3) in 300 microliters of the culture medium were plated onto 48-well culture plates (day 0). On day 2, 300 microliters of fresh culture medium was gently added to each well, and on day 4, 300 microliters of spent medium was replaced with the same volume of fresh medium. On day 6, the cultures were fixed and stained for tartrate-resistant acid phosphatase (TRAP) using commercial kits (Sigma). TRAP-positive multinucleated cells with more than 3 nuclei were defined as osteoclast-like (OC-like) cells, and manually counted under microscope.
  • TRAP tartrate-resistant acid phosphatase
  • 5TGM1 cells and marrow cells were co-cultured on 5x5 mm whale dentine slices in the same condition, and resorption pits formed on these dentine slices were examined by scanning electron microscopy as described (Yoneda 1992).
  • co-cultures of 5TGM1 myeloma cells and marrow cells were performed using transwell inserts (Becton Dickinson Labware) to prevent direct contact between these two types of cells. (2 e 6, 24-well plates, Costar). Marrow cells were plated in the lower chambers and 5TGM 1 myeloma cells (2e 3) were then plated in either lower (direct contact) or upper (no contact) chambers.
  • Conditioned media harvested from 5TGM1 cultures were assayed for bone-resorbing activity by organ cultures of 45Ca-labelled fetal rat long bones as described previously (Mbalaviele 1995).
  • Pregnant rats were injected with 250 uCi of 45Ca (New England Nuclear) on the 18 th day of gestation.
  • Radius and ulna bone shafts were obtained from 19-day fetuses by microdissection, and precultured for 24 h in BGJ medium (Sigma) supplemented with 0.1 % BSA between air and liquid-phase on stainless mesh grids. Bones were then cultured in the presence of conditioned media (50% v/v) or in control medium for 120 hours. The media were changed once at 48 hours.
  • ST2 cells (0.5 e 6) and 5TGM1 (4 e 6) cells were plated together onto 60-mm culture dishes (Beckton Dickinson) in 10% FBS-supplemented IMDM and cultured overnight, washed with serum-free IMDM twice, and incubated in 5 ml of serum-free IMDM. After 48 h, conditioned media were harvested and stored at -70°C until use.
  • mice were injected with 1 e 5 5TGM1 cells, which were allowed to colonize the bone marrow. Mice were split into two groups of three, one serving as a control group, and the second treated biweekly beginning on day 8 with 80 ug mAb PS/2 (4 mg/kg). Levels of IgG2b, the antibody isotype produced by 5TGM 1 myeloma cells, were measured weekly from weeks 1 to 6.
  • VCAM-1 and integrin VLA-4 were expressed in bone marrow stromal cells and myeloma cells, respectively.
  • both the ST2 stromal cell line and primary bone marrow stromal cells expressed VCAM-1, while 5TGM1 did not.
  • the 5TGM1 myeloma cells expressed integrin VLA-4, whereas stromal cells did not (data not shown).
  • both anti-VCAM-1 antibody (10 ug/ml) and VLA-4 antibody (10 ug/ml) partially (50-80%) inhibited the attachment of 5TGM1 cells to ST2 monolayers, showing that VCAM-1 and the VLA-4 integrin expressed on these cells are biologically functional and that these antibodies have neutralizing activity (data not shown).
  • OC-like cells On day 6 of the coculture of 5TGM1 cells and mouse marrow cells, numerous TRAP-positive multinucleated osteoclast-like (OC-like) cells were formed. These OC-like cells exhibited resorption pit formation on dentine slices, demonstrating that these cells were capable of resorbing bone, and possess an osteoclastic phenotype. In experiments using transwell inserts, formation of OC-like cells was observed when 5TGM1 cells were cultured in direct contact with bone marrow cells. In contrast, there was only a marginal number of OC-like cells formed when 5TGM1 cells were separated from marrow cells by the transwell membrane. Thus 5TGM1 cells induce osteoclast formation in mixed marrow cultures, and this induction requires direct cell-cell contact.
  • VCAM-1 Ab VCAM-1 Ab, 10ug/ml
  • VLA-4-integrin antibody alpha4beta1 Ab, 10 ug/ml
  • mAb against ICAM-1 another adhesion molecule on marrow stromal cells implicated in stromal/myeloma interactions, had no effect on OC-like cell formation ( Figure 1 ).
  • VCAM-1 and VLA-4 mAbs were examined on OC-like cell formation induced by 1,25 (OH) 2 D 3 , a widely-used stimulator of osteoclastogenesis in mouse bone marrow cell cultures (Takahashi 1988).
  • OC-like cell formation induced by 1,25 (OH) 2 D 3 a widely-used stimulator of osteoclastogenesis in mouse bone marrow cell cultures.
  • Neither VCAM-1 Ab nor VLA-4 mAb inhibited OC-like cell formation induced by vitamin D3, which itself had no effect on VCAM-1 expression in stromal cells (data not shown).
  • Conditioned medium from the co-culture of 5TGM 1 cells and ST2 cells showed a marked increase in bone resorption in the fetal rat long bone assay ( Figure 2 ), while conditioned medium of 5TGM1 caused only a marginal increase, s compared to control medium.
  • Conditioned medium from ST2 cells showed no increase in bone resorption.
  • Conditioned medium of 5TGM1 treated with a soluble recombinant form of VCAM-1 increased bone resorption in fetal rat long bones in a dose-dependent manner, while conditioned medium obtained from untreated 5TGM1 only marginally increased bone resorption. Soluble VCAM-1 itself had no effects on bone resorption (data not shown).
  • conditioned medium harvested from 5TGM1 cells treated with sVCAM-1 showed increased activity of OC-like cell formation, while conditioned medium of untreated 5TGM1 exhibited only marginal activity of OC-like cell formation ( Figure 3 ).
  • Rank ligand appears to be an important mediator of OCL formation and may be the final common pathway for the effects of osteoclastogenic cytokines on OCL formation.
  • 5TGM1 and ST2 cells both indivudually and when cocultured.
  • coculture of 5TGM1 and ST2 cells induces Rank ligand mRNA in the ST2 cells.
  • 5TGM1 cells do not expresss Rank ligand, they do so when treated with sVCAM-1 (not shown).
  • 5TGM1 cells alone produce marginal amount of activity that stimulates OC-like cell formation and bone resorption.
  • 5TGM1 myeloma cells were co-cultured with bone marrow cells containing hemopoietic osteoclast precursors and stromal cells, they strongly adhered to the stromal cells and increased OC-like cell formation. There were no OC-like cells formed in the co-cultures in which 5TGM1 cells were prevented from contacting stromal cells.
  • VCAM-1 and VLA-4 integrin play a role in this cell-cell interaction, since neutralizing antibodies to these two adhesion molecules profoundly decreased OC-like cell formation in the co-cultures.
  • the VCAM-1/VLA-4 integrin interaction is responsible for the cell-cell communication between marrow stromal cells and 5TGM 1 myeloma cells leading to increased production of a osteoclastogenic and bone-resorbing activity.
  • this bone resorbing activity in part is due to induction of Rank ligand.
  • mice were injected with STGM1 myeloma cells at day 0.
  • mice received no treatment; 9 mice received an isotype-matched control IgG mAb; 10 mice were treated with mAb PS/2 to alpha 4 integrin.
  • a different therapeutic regimen was given, in which mice were given a high dose of mAb (200 ug) on days 4,5, and 6, then a maintenance dose of 80 ug (- 4 mg/kg) every 3 days starting at day 8.

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